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Objective To investigate the clinical efficacy of piperacillin/tazobactam in the treatment of community acquired pneumonia (CAP).Methods 100 cases of CAP in Songyang People's Hospital from March 2016 to March 2017 were collected and randomly divided into two groups according to the digital table , with 50 cases in each group .The piperacillin/tazobactam group was treated with piperacillin/tazobactam , and the cefotaxime sodium group was given cefotaxime sodium .The clinical indicators ,symptoms and imaging effects ,blood indicators ,blood gas analysis and inflammatory indicators were compared between the two groups .Results The clinical symptoms disap-peared time,hospitalization time and hospitalization expenses in the piperacillin /tazobactam group were (3.77 ± 1.12)d,(8.44 ±2.47) d,(1780 ±489) CNY,respectively,which were significantly lower than those in the cefotaxime sodium group [(5.36 ±1.70)d,(11.37 ±3.68)d,(2136 ±470)CNY,t=5.523,4.675,3.711,all P<0.01].The effective rate of the piperacillin/tazobactam group was 90％,which was significantly higher than 70％ of the cefotaxime sodium group (χ2 =6.25,P <0.05).The effective rate of imaging treatment in the piperacillin /tazobactam group was 94％,which was significantly higher than 68％in the cefotaxime sodium group (χ2 =10.981, P<0.01).After treatment,the WBC and neutrophil percentage of the piperacillin/tazobactam group were (7.30 ± 1.08) ×109/L,(0.65 ±0.04),respectively,which were significantly lower than those of the cefotaxime sodium group [(8.66 ±1.25) ×109/L,(0.71 ±0.04),t=5.821,7.405,all P<0.01].The PaO2 level of the piperacillin/tazobactam group was significantly higher than that of the cefotaxime sodium group [(81.90 ±6.83)％vs.(74.20 ± 6.27)％,t=5.873,P<0.01].The levels of CRP,PCT,IL-1 and TNF-αin the piperacillin/tazobactam group
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Objective To investigate the clinical effect of atorvastatin combined with aspirin in the treatment of acute cerebral infarction ( ACI) .Methods 700 patients with ACI were selected ,and they were randomly divided into two groups according to the digital table ,with 350cases in each group.The control group was treated with aspirin .The observation group was given atorvastatin combined with aspirin .The neurological deficits ,daily living ability,overall treatment effect , disease related parameters and adverse reactions were compared between the two groups .Results After treatment,the NIHSS score,carotid IMT,plaque area,RI,TC,TG,LDL-C,hs-CRP,oxLDL,MDA,TNF-α, IL-6 and IL -1 levels in the observation group were (11.20 ±3.87) points,(1.04 ±0.13) mm,(0.51 ± 0.07)cm2,(63.26 ±2.56)%,(4.21 ±0.27)mmol/L,(1.32 ±0.12)mmol/L,(1.51 ±0.20)mmol/L,(1.61 ± 0.50)mg/L,(42.50 ±7.15) mg/L,(4.33 ±1.34)μmol/L,(419.65 ±51.16)μg/L,(120.04 ±22.50) ng/L, (310.45 ±44.82) ng/L,respectively,which were significantly lower than those in the control group [(14.79 ± 3.64)points,(1.20 ±0.17) mm,(0.67 ±0.12) cm2,(65.38 ±2.70)%,(4.76 ±0.36) mmol/L,(1.75 ± 0.17)mmol/L,(1.92 ±0.27) mmol/L,(2.32 ±0.67) mg/L,(60.15 ±9.15) mg/L,(6.19 ±1.40)μmol/L, (480.62 ±55.96)μg/L,(157.33 ±25.79)ng/L,(357.39 ±46.20)ng/L].The Barthel index,carotid artery lumen diameter,SV,DV,HDL-C and SOD levels in the observation group were (75.40 ±7.96),(7.57 ±0.24)mm, (0.789 ±0.18)m/s,(0.314 ±0.030)m/s,(1.69 ±0.15)mmol/L,(122.64±19.55)U/mL,respectively,which were significantly higher than those in the control group [(67.27 ±7.55),(7.23 ±0.28)mm,(0.673 ±0.125)m/s, (0.226 ±0.029)m/s,(1.42 ±0.20)mmol/L,(103.60 ±16.68)U/mL].The obvious effective rate and total effective rate of the observation group were 56.00% and 80.57%,respectively,which were significantly higher than those of the control group (39.71%and 68.00%,χ2 =18.599,14.478,all P<0.01).Conclusion Atorvastatin combined with aspirin in the treatment of patients with ACI has significant clinical effect and high safety .
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Objective To observe the therapeutic effect of modified Buyang Huanwu decoction combined with betahistine hydrochloride in the treatment of vertebral-basilar artery ischemic vertigo and its influence on hemorheological index.Methods 80 patients with vertebral-basilar artery ischemic vertigo were randomly divided into observation group and control group,40 cases in each group.The control group was given betahistine hydrochloride 12 mg,three times a day.The observation group was given modified Buyang Huanwu decoction on the basis of the control group, 4 weeks for a course.The DARS and DHI were measured before and after 4 weeks of treatment.The blood flow velocity was detected by transcranial Doppler ultrasonography, the difference of clinical curative effect between the two groups was compared.Results After treatment, the DARS and DHI scores of the observation group and control group were significantly decreased(t=14.716 and 5.258,20.662 and 14.609,all P<0.01).The DARS and DHI scores in the observation group were significantly lower than those in the control group (t=3.644,7.116,all P<0.05).After treatment,the average blood flow velocity of the vertebral artery, right vertebral artery and basilar artery in the observation group and the control group were significantly increased(t=11.216 and 7.447,10.103 and 7.204,11.303 and 6.642,all P<0.01).The average blood flow velocity of the vertebral artery, right vertebral artery and basilar artery in the observation group were significantly higher than those of the control group (t=4.405,4.761,5.824,all P<0.01).The total effective rate of the observation group was 95.00% (38/40),which was significantly higher than that of the control group (77.50%,31/40), the difference was statistically significant (Z=-2.000,P<0.05).Conclusion Modified Buyang Huanwu decoction combined with betahistine hydrochloride is effective in the treatment of vertebro-basilar ischemic vertigo.It can improve the blood supply to the brain and relieve the symptoms of vertigo, which is worthy of popularization and application.
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Objective To analyze risk factor in children with nosocomial infection of pediatric department. Methods 3 250 children were collected as observation group in recent five yesrs.The infective characteristic were analyzed retrospectively in observation group.Results 73 hospital infective cases were found in the observation group.50 cases of pulmonary infection,10 cases of digestive tract infection,10 cases of urinary system infection,and 3 cases of oral infection.Age(χ2 =5.76,P <0.05 ),duration of hospitalization(χ2 =6.05,P <0.05 ),invasive operation(χ2 =7.75,P <0.05)and preventive antibiotics use(χ2 =7.86,P <0.05)were correlated with nosocomial infection.Staphylococcus aureus and Staphylococcus haemolyticus of G + strain was most,staphlococcus epidemidis and klebsiella of G -strain was most.Conclusion The risk factors should be paied attention in paediatric cases,as well as strengthen the strict aseptic operation and apply with bacterial culture of secretion,which is of significance to guide clinical medication.
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Objective To study the anti-fibrotic function and mechanism of peroxisome proliferator activated receptorγ(PPARγ) in connective tissue disease-interstitial lung disease (CTD-ILD).Methods The expression of PPARγin lungs was analyzed in 37 cases with CTD-ILD and 20 control cases by immunohistochemistry.Changes in α-SMA levels were analyzed by Western blotting,and acetylation of Smad3 and Smad3 or PPARγ combined with P300 were analyzed by IP-WB.The data was analyzed by one-way ANOVA,t test or Mann-Whitney test.Results PPARγ' expression in the lung of CTD-ILD was lower than the controls [0.92％(1.44％),3.50％(1.94)％,respectively; Z=-8.924,P＜0.01].Different concentration of PPARγ (0,1,5,10,20,40 pmol/L) ligandinhibited the marked elevation of the protein α-SMA induced by TGF-β1 in a concentration-dependent manner (0.918 ±0.062,0.852±0.042,0.725 ±0.057,0.678 ±0.042,0.418 ±0.022,0.456±0.029; P＜0.05 or P＜0.01).However,this response was blocked by a selective antagonist PPARγ signaling GW9662 (0.946±0.087 vs 0.538±0.120,P＜0.01).Acetylation of Smad3 expression was increased when TGF-β1 was putted into lung fibroblasts after 60,90 and 180 min (0.565±0.047,1.127±0.101,0.873±0.022,0.614±0.407; all P＜0.05).The combination of Smad3 with P300 was also increased (1.46±0.12,0.98±0.09; P＜0.05),compared with the controls.But the ligand of PPARγ could block this effect (0.62±0.10,1.46±0.12; P＜0.05).Meanwhile,the combination of PPARγ and P300 was increased (0.94±0.05,0.76±0.22; P＜0.05).Conclusion PPARγ may play a physiologic role in the regulation of anti-fibrosis response.Its function may be realized by its competition with Smad3 combined with P300.